Effects of ulinastatin combined with dexmedetomidine on cognitive dysfunction and emergence agitation in elderly patients who underwent total hip arthroplasty

BACKGROUND With the continuous growth of the modern elderly population,the risk of fracture increases.Hip fracture is a common type of fracture in older people.Total hip arthroplasty(THA)has significant advantages in relieving chronic pain and promoting the recovery of hip joint function.AIM To investigate the effect of ulinastatin combined with dexmedetomidine(Dex)on the incidences of postoperative cognitive dysfunction(POCD)and emergence agitation in elderly patients who underwent THA.METHODS A total of 397 patients who underwent THA from February 2019 to August 2022.We conducted a three-year retrospective cohort study in Shaanxi Provincial People’s Hospital.Comprehensive demographic data were obtained from the electronic medical record system.We collected preoperative,intraoperative,and postoperative data.One hundred twenty-nine patients who were administered Dex during the operation were included in the Dex group.One hundred fifty patients who were intravenously injected with ulinastatin 15 min before anesthesia induction were included in the ulinastatin group.One hundred eighteen patients who were administered ulinastatin combined with Dex during the operation were included in the Dex+ulinastatin group.The patients’perioperative conditions,hemodynamic indexes,postoperative Mini-Mental State Examination(MMSE)scores,Ramsay score,incidence of POCD,and serum inflammatory cytokines were evaluated.RESULTS There was a significant difference in the 24 h visual analogue scale score among the three groups,and the score in the Dex+ulinastatin group was the lowest(P<0.05).Compared with the Dex and ulinastatin group,the MMSE scores of the Dex+ulinastatin group were significantly increased at 1 and 7 d after the operation(all P<0.05).Compared with those in the Dex and ulinastatin groups,incidence of POCD,levels of serum inflammatory cytokines in the Dex+ulinastatin group were significantly decreased at 1 and 7 d after the operation(all P<0.05).The observer’s assessment of the alertness/sedation score and Ramsay score of the Dex+ulinastatin group were significantly different from those of the Dex and ulinastatin groups on the first day after the operation(all P<0.05).CONCLUSION Ulinastatin combined with Dex can prevent the occurrence of POCD and emergence agitation in elderly patients undergoing THA.

Efficacy and safety of ulinastatin in the treatment of septic shock:a systematic review and meta-analysis

Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate the efficacy and safety of ulinastatin in the treatment of septic shock patients.Methods:Three English databases(Embase,Medline,and Cochrane Library)and four Chinese databases(China National Knowledge Infrastructure,Wanfang data,SinoMed,and VIP)were searched for published randomized controlled trials.Stata 16.0 software was used to conduct the meta-analysis.Results:A total of 48 articles were included(Chinese article 47,1 in English).The results show that the treatment of ulinastatin could reduce mortality(risk ratio=0.63,95%confidence interval(CI)(0.55,0.72)),multiple organ dysfunction syndrome(risk ratio=0.6,95%CI(0.53,0.68)),length of intensive care unit stay(mean difference(MD)=-3.92,95%CI(-4.65,-3.18)),length of hospital stay(MD=-4.39,95%CI(-6.63,-2.15))and decrease Acute Physiology and Chronic Health Evaluation II score(MD=-4.55,95%CI(-5.63,-3.47))and Sequential Organ Failure Assessment score(MD=-2.02,95%CI(-2.59,-1.44))with P<0.001.Moreover,it lowers TNF-α(standardized mean difference(SMD)=-1.78,95%CI(-2.24,-1.32)),Interleukin-6(SMD=-1.17,95%CI(-1.55,-0.8)),C reactive protein(SMD=-1.49,95%CI(-1.99,-0.99)),hypersensitive C-reactive protein(SMD=-1.9,95%CI(-2.87,-0.94))and procalcitonin(SMD=-0.89,95%CI(-1.12,-0.67))levels in the body.Conclusions:Available evidence shows that ulinastatin reduces case mortality rate,multiple organ dysfunction syndrome,length of intensive care unit stay,and length of hospital stay and decreases Acute Physiology and Chronic Health Evaluation II score and Sequential Organ Failure Assessment score.Moreover,it also lowers TNF-α,Interleukin-6,C reactive protein,hypersensitive C-reactive protein,and procalcitonin levels in the body.

Ulinastatin in the treatment of severe acute pancreatitis:A singlecenter randomized controlled trial

BACKGROUND Severe acute pancreatitis(AP)is one of the most common diseases of the gastrointestinal tract and carries a significant financial burden with high disability and mortality.There are no effective drugs in the clinical management of severe AP,and there is an absence of evidence-based medicine concerning the treatment of severe AP.AIM To explore whether ulinastatin(UTI)can improve the outcome of severe AP.METHODS The present research included patients who were hospitalized in intensive critical care units(ICUs)after being diagnosed with severe AP.Patients received UTI(400000 IU)or placebos utilizing computer-based random sequencing(in a 1:1 ratio).The primary outcome measures were 7-d mortality,clinical efficacy,inflammatory response,coagulation function,infection,liver function,renal function,and drug-related adverse effects were evaluated.RESULTS A total of 181 individuals were classified into two groups,namely,the placebo group(n=90)and the UTI group(n=91).There were no statistically significant differences in baseline clinical data between the two groups.The 7-d mortality and clinical efficacy in the UTI group were remarkably improved compared with those in the placebo group.UTI can protect against hyperinflammation and improve coagulation dysfunction,infection,liver function,and renal function.UTI patients had markedly decreased hospital stays and hospitalization expenditures compared with the placebo group.CONCLUSION The findings from the present research indicated that UTI can improve the clinical outcomes of patients with severe AP and has fewer adverse reactions.

Effects of ulinastatin therapy in deep vein thrombosis prevention after brain tumor surgery:A single-center randomized controlled trial

BACKGROUND Venous thromboembolism(VTE)is a common neurosurgical complication after brain tumor resection,and its prophylaxis has been widely studied.There are no effective drugs in the clinical management of venous thromboembolism,and there is an absence of evidence-based medicine concerning the treatment of severe multiple traumas.AIM To explore whether ulinastatin(UTI)can prevent VTE after brain tumor resection.METHODS The present research included patients who underwent brain tumor resection.Patients received UTIs(400,000 IU)or placebos utilizing computer-based random sequencing(in a 1:1 ratio).The primary outcome measures were the incidence of VTE,coagulation function,pulmonary emboli,liver function,renal function,and drug-related adverse effects.RESULTS A total of 405 patients were evaluated between January 2019 and December 2021,and 361 of these were initially enrolled in the study to form intention-to-treat,which was given UTI(n=180)or placebo(n=181)treatment in a random manner.There were no statistically significant differences in baseline clinical data between the two groups.The incidence of VTE in the UTI group was remarkably improved compared with that in the placebo group.UTI can improve coagulation dysfunction,pulmonary emboli,liver function,and renal function.No significant difference was identified between the two groups in the side effects of UTI-induced diarrhea,vomiting,hospital stays,or hospitalization costs.The incidence of allergies was higher in the UTI group than in the placebo group.CONCLUSION The findings from the present research indicated that UTI can decrease the incidence of VTE and clinical outcomes of patients after brain tumor resection and has fewer adverse reactions.

Ulinastatin suppresses endoplasmic reticulum stress and apoptosis in the hippocampus of rats with acute paraquat poisoning

Lung injury is the main manifestation of paraquat poisoning. Few studies have addressed brain damage after paraquat poisoning. Ulinastatin is a protease inhibitor that can effectively stabilize lysosomal membranes, prevent cell damage, and reduce the production of free radicals. This study assumed that ulinastatin would exert these effects on brain tissues that had been poisoned with paraquat. Rat models of paraquat poisoning were intraperitoneally injected with ulinastatin. Simultaneously, rats in the control group were administered normal saline. Hematoxylin-eosin staining showed that most hippocampal cells were contracted and nucleoli had disappeared in the paraquat group. Fewer cells in the hippocampus were concentrated and nucleoli had dis- appeared in the ulinastatin group. Western blot assay showed that expressions of GRP78 and cleaved-caspase-3 were significantly lower in the ulinastatin group than in the paraquat group. Immunohistochemical findings showed that CHOP immunoreactivity was significantly lower in the ulinastatin group than in the paraquat group. Terminal deoxynucleotidyl transferase-medi- ated dUTP nick end labeling staining showed that the number of apoptotic cells was reduced in the paraquat and ulinastatin groups. These data confirmed that endoplasmic reticular stress can be induced by acute paraqnat poisoning. Ulinastatin can effectively inhibit this stress as well as cell apoptosis, thereby exerting a neuroprotective effect.

Effect of ulinastatin combined rivaroxaban on deep vein thrombosis in major orthopedic surgery

Objective:To explore the effect of ulinastatin(UTI) continuous infusion combined Rivaroxaban on the deep vein thrombosis in patients undergoing major orthopedic surgery.Methods:Forty-five patients undergoing major orthopedic surgery were randomly divided into three groups:ulinastatin continuous infusion(Uc) group,ulinastatin single injection(Us) group and control(C) group.All patients received patient-controlled intravenous analgesia(PCIA) after operation,and took Rivaroxaban 10 mg orally 12 hours after operation.Ulinastatin(5 000 U/kg)was given intravenously to both Uc and Us groups preoperatively.Group C was given isometric normal saline,group Uc was pumped UTI continuous intravenously at the end of surgery(10 000U/kg) to 48 hours through PCIA pump.The values of hematocrit(HCT),thrombomodulin(TM),Interleukin(IL-6),thrombin-antithrombin complex(TAT),D-Dimer(D-D) were normally tested before surgery(T1),at the end of the surgery(T2),12 hours(T3).24 hours(T4) and 48 hours(T5)after surgery.Results:Compared with T1,there was an upward tendency in TM,IL-6,TAT,and D-D after operation in group C group(P <0.05).The values of them were significandy increased from nearly 24-hour after surgery in Us group(P<0.05).In group Uc.there were no significant changes in these indices after operation(P>0.05).Conclusions:During the perioperative period,ulinastatin continuous infusion combined Rivaroxaban can correct blood hypercoagulability through different approaches in patients undergoing major orthopedic surgery.

尿胰蛋白酶抑制剂Ulinastatin对lewis肺癌小鼠肿瘤生长和转移的抑制作用

目的探讨尿胰蛋白酶抑制剂(UTI)在动物模型上抗肿瘤作用。方法选用尿胰蛋白酶抑制剂乌司他丁(Ulinastatin),Lewis肺癌小鼠模型;雄性C57BL/6小鼠40只,接种lewis肿瘤细胞,分成生理盐水组(对照组)、环磷酰胺组(CTX)、Ulinastatin2.5万单位组、Ulinastatin5万单位组、Ulinastatin10万单位组,各8只,接种后第6天,开始腹腔给药,记录皮下瘤长短径变化,做生长曲线;接种14天后处死所有小鼠,统计皮下平均瘤重和肺转移灶个数,使用流式细胞计分析凋亡率(AR)增值百分比(SPF)。结果皮下瘤重依次为(7.92±2.52、0.66±0.50、3.47±1.45、3.08±0.81、1.70±1.05)g,平均肺转移灶依次为(8.625±1.407、1.125±1.126、1.625±1.302、1.00±0.75、0.625±0.74)。CTX组(39.3±4.8)%和Ulinastatin10万单位组(40.2±3.1)%的AR值明显增加,Ulinastatin未见SPF值明显减少。结论Ulinastatin对lewis肺癌小鼠的转移瘤生长和自发性肺转移有抑制作用。

Ulinastatin for acute lung injury and acute respiratory distress syndrome: A systematic review and meta-analysis

AIM: To investigate the efficacy and safety of ulinastatin for patients with acute lung injury(ALI) and those with acute respiratory distress syndrome(ARDS).METHODS: A systematic review of randomized controlled trials(RCTs) of ulinastatin for ALI/ARDS was conducted. Oxygenation index, mortality rate [intensive care unit(ICU) mortality rate, 28-d mortality rate] and length of ICU stay were compared between ulinastatin group and conventional therapy group. Meta-analysis was performed by using Rev Man 5.1.RESULTS: Twenty-nine RCTs with 1726 participants were totally included, the basic conditions of which were similar. No studies discussed adverse effect. Oxygenation index was reported in twenty-six studies(1552 patients). Ulinastatin had a significant effect in improving oxygenation [standard mean difference(SMD) = 1.85, 95%CI: 1.42-2.29, P < 0.00001, I2 = 92%]. ICUmortality and 28-d mortality were respectively reported in eighteen studies(987 patients) and three studies(196 patients). We found that ulinastatin significantly decreased the ICU mortality [I2 = 0%, RR = 0.48, 95%CI: 0.38-0.59, number needed to treat(NNT) = 5.06, P < 0.00001], while the 28-d mortality was not significantly affected(I2 = 0%, RR = 0.78, 95%CI: 0.51-1.19, NNT = 12.66, P = 0.24). The length of ICU stay(six studies, 364 patients) in the ulinastatin group was significantly lower than that in the control group(SMD =-0.97, 95%CI:-1.20--0.75, P < 0.00001, I2 = 86%). CONCLUSION: Ulinastatin seems to be effective for ALI and ARDS though most trials included were of poor quality and no information on safety was provided.

Effect of ulinastatin on paraquat-induced-oxidative stress in human type Ⅱ alveolar epithelial cells

BACKGROUND： Ulinastatin （UTI） is a urinary trypsin inhibitor extracted and purified from urine of males. This study aimed to explore the effects of UTI on paraquat-induced-oxidative stress in human type II alveolar epithelial cells. METHODS： The human type II alveolar epithelial cells, A549 cells, were cultured in vitro. The A549 cells were treated with different concentrations of paraquat （200, 400, 600, 800, 1 000, 1 200 pmol/L） and ulinastatin（0, 2 000, 4 000, 6 000, 8 000 U/mL） for 24 hours, the cell viability was measured by cell counting kit-8 and the median lethal concentration was selected. In order to establish an in vitro model of paraquat intoxication and to determine the safe dose of ulinastatin, we calculated LD50 using cell counting kit-8 to determine the survival rate of the cells. A549 cells were divided into normal control group, paraquat group and paraquat＋ulinastatin group. The levels of malondialdehyde （MDA） and myeloperoxidase （MPO） were detected by biochemistry colorimetry, while the level of reactive oxygen spies （ROS） was detected by DCFH-DA assay. RESULTS： The survival rate of A549 cells treated with different concentrations of paraquat decreased in a concentration-dependent manner. Whereas there was no decrease in the survival rate of cells treated with 0-4 000 U/mL ulinastatin. The levels of MDA, MPO, and ROS were significantly higher in the paraquat group than in the normal control group after 24-hour-exposure. And the survival rate of the paraquat＋ulinastatin group was higher than that of the paraquat group, but lower than that of the normal control group. The levels of MDA, MPO, and ROS were lower than those of the paraquat group. CONCLUSION： Ulinastatin can alleviate the paraquat-induced A549 cell damage by reducing oxidative stress.

Prospective experimental studies on the renal protective effect of ulinastatin after paraquat poisoning

BACKGROUND:Paraquat(PQ) is an effective herbicide and is widely used in agricultural production,but PQ poisoning is frequently seen in humans with the lung as the target organ.Currently,there are many studies on lung injury after PQ poisoning.But the kidney as the main excretory organ after PQ poisoning is rarely studied and the mechanisms of this poisoning is not very clear.In this study,we observed the expression of caspase-3 and livin protein in rat renal tissue after PQ poisoning as well as the therapeutic effects of ulinastatin.METHODS:Fifty-four Sprague-Dawley(SD) rats were randomly divided into three experimental groups:control group(group A),paraquat poisoning group(group B) and ulinastatin group(group C),with 18 rats in each group.Rats in group B and group C were administered intragastrically with 80mg/kg PQ,rats in group C were injected peritoneally with 100 000 U/kg ulinastatin once a day,while rats in group A were administered intragastrically with the same volume of saline as PQ.At 24,48,72 hours after poisoning,the expression of livin in renal tissue was detected by Westen blotting,the expression of caspase-3 was detected by immunohistochemistry,and the rate of renal cell apoptosis was tested by TUNEL detection.The histopathological changes were observed at the same time.RESULTS:Compared to group A,the expression of caspase-3 in the renal tissue of rats in groups B and C increased significantly at any time point.Compared with group B,the expression of caspase-3 in renal tissue of rats in group C decreased.Compared with group A,the expression of livin in renal tissue in rats of groups B and C increased significantly at any time point(P<0.01),especially in group C(P<0.01).TUNEL method showed that the rate of renal cell apoptosis index was higher in group B at corresponding time points than in group A(P<0.01),and was lower in group C at corresponding time points than in group B(P<0.01).CONCLUSION:UTI has a protective effect on the renal tissue of rats after paraquat poisoning through up-regulating the expression of livin and down-regulating the expression of caspase-3,but the regulation path still needs a further research.

Effect of ulinastatin on hepatic ischemia-reperfusion injury in rats

Objective To investigate the effect of ulinastatin(UTI)on hepatic ischemia-reperfusion injury in rats.Methods Totally 24 adult Sprague-Dawley rats were randomly divided into 3 groups:sham-operated control group(SO group),ischemia-reperfusion group(I/R group)and ulinastatin group(UTI group).Liver in I/R group underwent 1 h of reperfusion after 30 min of ischemia.In UTI group,UTI(2×104 U/kg)was administered to rats 30 min before modeling.The levels of alanine aminotransferase,aspartate aminotransferase and tumor necrosis factor-alpha(TNF-α)in serum were measured and the levels of nitric oxide and malondialdehyde in liver were determined.The histological changes of liver were observed.Results The levels of alanine aminotransferase,aspartate aminotransferase and TNF-α in serum were significantly increased in I/R group compared with those in UTI group(P<0.05).The levels of nitric oxide and malondialdehyde in liver were significantly higher in I/R group than in UTI group(P<0.05).Histological examination of liver indicated that the damages were more severe in I/R group than in UTI group.Conclusion UTI has the ability to inhibit the production of TNF-α and oxyradical,and ameliorate microcirculatory dysfunction in rats with hepatic ischemia-reperfusion injury.

Effects of Xuebijing Combined with Ulinastatin on Coagulation Function of Sepsis Patients

[Objectives] To study the effects of Xuebijing combined with ulinastatin on coagulation function of sepsis patients. [Methods]Fifty six patients conforming to the diagnosis criteria for sepsis and receiving the treatment from May 2015 to January 2019 were selected. They were randomly divided into treatment group and control group according to the order of treatment. The two groups were treated according to the International Guidelines for Management of Severe Sepsis and Septic Shock( 2012),in which ulinastatin and Xuebijing were added to the treatment group. Before the treatment and on the seventh day after the treatment,both groups of patients were measured for the activated partial thromboplastin time( APTT),fibrinogen( Fi B),platelet( PLT),and prothrombin time( PT) were measured;the treatment status of the both groups was continuously observed for 7 d,and the mechanical ventilation time,ICU hospitalization time,and 30-day survival rate were recorded. [Results] Both FIB and PLT of the treatment group were significantly increased,and both APTT and PT were significantly shortened.Compared with the control group,the difference was statistically significant( P < 0. 05). The mechanical ventilation time and ICU hospitalization time of the treatment group were significantly shorter than that of the control group,and the 30-day survival rate of the treatment group was significantly higher than that of the control group,and the difference was statistically significant( P < 0. 05). [Conclusions]Xuebijing combined with ulinastatin can improve coagulation disorders of sepsis patients.

Effects of ulinastatin combined with surgery on nerve injury, oxygen free radicals and inflammatory factors production of patients with hypertensive intracerebral hemorrhage

Objective: To study the effects of ulinastatin combined with surgery on nerve injury, oxygen free radicals and inflammatory factors production of patients with hypertensive intracerebral hemorrhage. Methods: The patients with hypertensive intracerebral hemorrhage received surgical treatment in our hospital during February 2015 - December 2017 were selected and divided into two groups by random number table. The observation group received ulinastatin combined surgery and the control group received conventional medicine combined with surgery. Before treatment and 1 weeks after treatment, serum levels of nerve damage markers, neurotrophic indexes, oxygen free radicals production indexes and inflammatory cytokines were measured. Results: After treatment, the contents of NSE, VILIP-1, GFAP, S100B, MDA, AOPP, 8-OHdG, NO, ET-1, TNF-α, sICAM-1, sVCAM-1, sICAM-1 of two groups were all decreased, the contents of BDNF, NGF, VEGF, IGF-I were all increased and the decreasing trend of NSE, VILIP-1, GFAP, S100B, MDA, AOPP, 8-OHdG, NO, ET-1, TNF-α, sICAM-1, sVCAM-1, sICAM-1 of observation group was more obvious than that of the control group, the increasing trend of BDNF, NGF, VEGF, IGF-I content was more obvious than that of the control group. Conclusion: The use of ulinastatin combined with surgery in the treatment of hypertensive intracerebral hemorrhage can significantly reduce the damage of nerve function and reduce the production of oxygen free radicals and inflammatory factors.

Protective effect of methylprednisolone combined with ulinastatin pretreatment on inflammatory lung injury induced by anesthesia for esophageal cancer

Objective:To investigate the protective effect of methylprednisolone combined with ulinastatin pretreatment on inflammatory lung injury induced by single-lung ventilation.Methods: A total of 120 patients with radical resection of cancer surgery admitted to our hospital from January 2016 to December 2017 were randomly divided into control group, methylprednisolone group, ulinastatin group, and methylprednisolone combined with ulinastatin pretreatment group. Before single lung ventilation (T0), 30 min after ventilation (T1), and 60 min (T2) after the end of ventilation, enzyme-linked immunosorbent kit method was used to detect the levels of inflammatory factors TNF-α, IL-8 and IL-10. The mean airway pressure (Pmean) at each monitoring point and the oxygenation indexes (PaO2/FiO2) before and after surgery were detected. And also, the extraction time, drainage volume and sputum volume of the drainage tube after surgery were measured.Results:Compared with the control group, the other three groups can reduce the levels of TNF-α and IL-8 in the blood of patients with esophageal cancer, improve IL-10 and increase the oxygenation index (P<0.05). However, methylprednisolone combined with ulinastatin pretreatment group was significantly better than methylprednisolone group and ulinastatin group in reducing serum inflammatory factor levels and increasing oxygenation index. In addition, the drainage tube extraction time, drainage volume and sputum volume of the patients treated with methylprednisolone combined with ulinastatin were also significantly lower than those of the control group, the methylprednisolone group and the ulinastatin group.Conclusions: Methylprednisolone combined with ulinastatin has a synergistic protective effect on inflammatory lung injury caused by radical resection of esophageal cancer patients, which is worthy of first-line clinical recommendation.

Efficacy of Ulinastatin Combined with Continuous Renal Replacement Therapy in the Treatment of Sepsis Acute Kidney Injury and Its Effects on Systemic Inflammation, Immune Function and miRAN Expression

Objective: To research the effectiveness of ulinastatin in combination with continuous renal replacement therapy in treating sepsis acute kidney injury and its effect on systemic inflammation, immune function and miRAN expression. Methods: The 84 patients who were diagnosed with sepsis complicated by acute kidney injury in our hospital between May 2020 and June 2022 were chosen and randomly assigned to the study group (n = 42) and the control group (n = 42). Ulinastatin in combination with continuous renal replacement therapy was administered to the study group, whereas the control group was administered with continuous renal replacement therapy alone. Both groups’ clinical effects were observed. The levels of blood urea nitrogen (BUN), serum creatinine (SCr), tumor necrosis factor-α (TNF-α), high sensitivity Creactive protein (hs-CRP), vascular cell adhesion molecule-1 (VCAM-1), IgG, IgA, IgM, expression levels of miR-233 and miR-10a were compared among both the groups, pre-, and post-treatment. Results: The study group’s overall effectiveness rate was higher that is 95.24%, in comparison to the control group’s 78.57%, and this difference was statistically significant (P α, hs-CRP, VCAM-1, and miR-233 and miR-10a expression levels in both the study and control groups were decreased, however, the study group had reduced levels in comparison to the control group, with statistically significant differences (P P Conclusion: Ulinastatin in combination with continuous renal replacement therapy for treating sepsis acute kidney injury exhibits a positive effect and can significantly improve the systemic inflammation and immune function in patients.

Effect of ulinastatin combined with antibiotics on systemic inflammatory response and stress hormone secretion in patients with acute severe pneumonia

Objective:To study the effect of ulinastatin combined with antibiotics on systemic inflammatory response and stress hormone secretion in patients with acute severe pneumonia. Methods: A total of 78 patients with acute severe pneumonia in our hospital between December 2014 and January 2017 were randomly divided into routine group and ulinastatin group, each with 39 cases. Routine group were treated with conventional antibiotics, ulinastatin group were treated with ulinastatin and antibiotics, and the treatments lasted for 2 weeks. The differences of serum acute phase proteins, inflammatory factors and stress hormones were compared between the two groups before and after treatment.Results: Before treatment, there were no significant differences in serum contents of acute phase proteins, inflammatory factors or stress hormones between the two groups. After 2 weeks of treatment, serum acute phase protein prealbumin (PA) content in ulinastatin group was higher than that in routine group whereas C-reactive protein (CRP) content was lower than that in routine group;serum inflammatory cytokines interleukin-1β (IL-1β), interleukin-2 (IL-2) and interleukin-6 (IL-6) contents in ulinastatin group were lower than those in routine group;serum stress hormones NE, Cor and AngII contents in ulinastatin group were lower than those in routine group. Conclusion:Ulinastatin combined with antibiotics for acute severe pneumonia can inhibit the systemic inflammatory response and stress response.

Effects of ulinastatin + danshen + somatostatin on inflammation and oxidative stress in patients with severe pancreatitis

Objective: To explore the effects of ulinastatin + danshen + somatostatin on inflammation and oxidative stress in patients with severe pancreatitis. Methods: A total of 72 patients with severe acute pancreatitis who were treated in this hospital between September 2014 and December 2016 were divided into control group (n=36) and study group (n=36) by random number table method, control group received conventional treatment combined with danshen + somatostatin therapy, and study group received conventional treatment combined with ulinastatin + danshen+ somatostatin therapy. The differences in the levels of systemic inflammation and oxidative stress indexes were compared between the two groups before and after treatment. Results:Immediately after admission, the differences in the serum levels of inflammatory mediators and oxidative stress indexes were not statistically significant between the two groups. After 10 d of treatment, inflammatory mediators IL-1β, IL-6, sICAM-1 and PCT levels in the serum samples of study group were lower than those of control group;oxidation indexes MDA, LHP and AOPPs levels in serum samples of study group were lower than those of control group whereas anti-oxidation indexes SOD, GSH-Px and CAT levels were higher than those of control group. Conclusion: Ulinastatin + danshen + somatostatin therapy can effectively inhibit the inflammation and oxidative stress in patients with severe pancreatitis.

Effects of ulinastatin combined with thymopentin on cellular immunity, humoral immunity and stress response in severe pneumonia

Objective:To explore the effects of ulinastatin combined with thymopentin on cellular immunity, humoral immunity and stress response in severe pneumonia.Methods: A total of 102 cases of severe pneumonia treated in our hospital from February 2016 to November 2017 were collected as subjects and randomly divided into the control group (n=51) and the observation group (n=51), the two groups were treated with routine symptomatic treatment. The control group was treated with the ulinastatin on the basis of routine treatment, the observation group was treated with thymopentin on the basis of the control group. The changes of cellular immunity, humoral immunity, stress response and liver function in the two groups were compared.Results: Before treatment, there was no significant difference in the levels of CD4+, CD8+, CD4+/CD8+, IgA, IgM, IgG, SOD, MDA, T-AOC, AKP, TB and ALT between the two groups (P>0.05). After treatment, the two groups of CD4+ and CD4+ /CD8+ were significantly increased (P<0.05), CD8+ was significantly lower than before treatment (P<0.05), and CD4+ and CD4+ /CD8+ in the observation group were significantly increased compared with the control group (P<0.05), CD8+was significantly lower than the control group (P<0.05);the two groups of IgA, IgM and IgG were significantly increased compared with those before treatment (P<0.05), and the IgA, IgM and IgG in the observation group were significantly higher than those in the control group (P<0.05);two groups of SOD and T-AOC were significantly higher than before treatment (P<0.05), while MDA was significantly lower than before treatment (P<0.05), and SOD and T-AOC in the observation group were significantly increased (P<0.05), and MDA was significantly lower than that of the control group (P<0.05);two groups of AKP, TB and ALT were significantly lower than those before treatment (P<0.05), and the AKP, TB and ALT in the observation group were significantly lower than those in the control group (P<0.05).Conclusions: ulinastatin combined with thymopentin in patients with severe pneumonia can effectively enhance the cellular immunity and humoral immune function, reduce oxidative stress damage and protect the liver function, which has clinical significance.

Effect of ulinastatin on the pathological links related to myocardial injury and ischemia reperfusion after cardiac surgery under cardiopulmonary bypass

Objective: To study the effect of ulinastatin on the pathological links related to myocardial injury and ischemia reperfusion after cardiac surgery under cardiopulmonary bypass. Methods: The patients undergoing valve replacement under cardiopulmonary bypass between February 2015 and December 2017 in Mianyang Central Hospital of Sichuan Province were chosen as the research subjects and randomly divided into the experimental group who accepted ulinastatin + creatine phosphate sodium intervention and the control group who accepted creatine phosphate sodium intervention. The levels of myocardial injury markers, apoptosis molecules, inflammation molecules and oxidative stress molecules in serum as well as the expression intensity of inflammation molecules and oxidative stress molecules in peripheral blood were determined before surgery and 24 h after surgery. Results: Serum cTnI, CK-MB, H-FABP, sFasL, sTWEAK, Caspase-3, Caspase-8, IL-1β, TNF-α, ICAM1, MDA and NO levels as well as peripheral blood TLR4, NLRP3, NOX2 and iNOS expression intensity of both groups of patients after surgery were significantly higher than those before surgery, and serum cTnI, CK-MB, H-FABP, sFasL, sTWEAK, Caspase-3, Caspase-8, IL-1β, TNF- , ICAM1, MDA and NO levels as well as peripheral blood TLR4, NLRP3, NOX2 and iNOS expression intensity of experimental group after surgery were significantly lower than those of control group. Conclusion: Ulinastatin can improve the apoptosis, inflammation and oxidative stress related to myocardial injury and ischemia reperfusion after cardiac surgery under cardiopulmonary bypass.

Effects of ulinastatin on immune function, oxidative stress and related factors in patients with acute pancreatitis

Objective: To investigate the effects of ulinastatin on immune function, oxidative stress and related factors in patients with acute pancreatitis. Methods: 120 patients with acute pancreatitis admitted to digestive department of our hospital from May 2016 to May 2018 were randomly divided into control group and observation group, 60 cases in each group. Patients in the control group were given routine treatment, while patients in the observation group were given ulinastatin on the basis of the treatment of patients in the control group. The levels of Kim-1, Cys C, BUN, IgA, IgM, IgG, SOD, NO, TAC, PCT and CRP of patients in the two groups were detected and compared before and after treatment. Results: After treatment, the serum levels of Kim-1, Cys C, BUN, NO, PCT and CRP of patients in the control group and the observation group decreased significantly and the serum levels of IgA, IgG, IgM, SOD and TAC increased significantly. The change trend of these indexes in the serum of patients in the observation group was more obvious than those of patients in the control group (P<0.05). Conclusion: Ulinastatin in the treatment of acute pancreatitis can significantly alleviate kidney injury, enhance immune function and antioxidant capacity of patients, alleviate inflammation.